HB4096 EngrossedLRB099 07770 RLC 27903 b

1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Administrative Procedure Act is
5amended by changing Section 5-45 as follows:
 
6    (5 ILCS 100/5-45)  (from Ch. 127, par. 1005-45)
7    Sec. 5-45. Emergency rulemaking.
8    (a) "Emergency" means the existence of any situation that
9any agency finds reasonably constitutes a threat to the public
10interest, safety, or welfare.
11    (b) If any agency finds that an emergency exists that
12requires adoption of a rule upon fewer days than is required by
13Section 5-40 and states in writing its reasons for that
14finding, the agency may adopt an emergency rule without prior
15notice or hearing upon filing a notice of emergency rulemaking
16with the Secretary of State under Section 5-70. The notice
17shall include the text of the emergency rule and shall be
18published in the Illinois Register. Consent orders or other
19court orders adopting settlements negotiated by an agency may
20be adopted under this Section. Subject to applicable
21constitutional or statutory provisions, an emergency rule
22becomes effective immediately upon filing under Section 5-65 or
23at a stated date less than 10 days thereafter. The agency's

 

 

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1finding and a statement of the specific reasons for the finding
2shall be filed with the rule. The agency shall take reasonable
3and appropriate measures to make emergency rules known to the
4persons who may be affected by them.
5    (c) An emergency rule may be effective for a period of not
6longer than 150 days, but the agency's authority to adopt an
7identical rule under Section 5-40 is not precluded. No
8emergency rule may be adopted more than once in any 24 month
9period, except that this limitation on the number of emergency
10rules that may be adopted in a 24 month period does not apply
11to (i) emergency rules that make additions to and deletions
12from the Drug Manual under Section 5-5.16 of the Illinois
13Public Aid Code or the generic drug formulary under Section
143.14 of the Illinois Food, Drug and Cosmetic Act, (ii)
15emergency rules adopted by the Pollution Control Board before
16July 1, 1997 to implement portions of the Livestock Management
17Facilities Act, (iii) emergency rules adopted by the Illinois
18Department of Public Health under subsections (a) through (i)
19of Section 2 of the Department of Public Health Act when
20necessary to protect the public's health, (iv) emergency rules
21adopted pursuant to subsection (n) of this Section, (v)
22emergency rules adopted pursuant to subsection (o) of this
23Section, or (vi) emergency rules adopted pursuant to subsection
24(c-5) of this Section. Two or more emergency rules having
25substantially the same purpose and effect shall be deemed to be
26a single rule for purposes of this Section.

 

 

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1    (c-5) To facilitate the maintenance of the program of group
2health benefits provided to annuitants, survivors, and retired
3employees under the State Employees Group Insurance Act of
41971, rules to alter the contributions to be paid by the State,
5annuitants, survivors, retired employees, or any combination
6of those entities, for that program of group health benefits,
7shall be adopted as emergency rules. The adoption of those
8rules shall be considered an emergency and necessary for the
9public interest, safety, and welfare.
10    (d) In order to provide for the expeditious and timely
11implementation of the State's fiscal year 1999 budget,
12emergency rules to implement any provision of Public Act 90-587
13or 90-588 or any other budget initiative for fiscal year 1999
14may be adopted in accordance with this Section by the agency
15charged with administering that provision or initiative,
16except that the 24-month limitation on the adoption of
17emergency rules and the provisions of Sections 5-115 and 5-125
18do not apply to rules adopted under this subsection (d). The
19adoption of emergency rules authorized by this subsection (d)
20shall be deemed to be necessary for the public interest,
21safety, and welfare.
22    (e) In order to provide for the expeditious and timely
23implementation of the State's fiscal year 2000 budget,
24emergency rules to implement any provision of this amendatory
25Act of the 91st General Assembly or any other budget initiative
26for fiscal year 2000 may be adopted in accordance with this

 

 

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1Section by the agency charged with administering that provision
2or initiative, except that the 24-month limitation on the
3adoption of emergency rules and the provisions of Sections
45-115 and 5-125 do not apply to rules adopted under this
5subsection (e). The adoption of emergency rules authorized by
6this subsection (e) shall be deemed to be necessary for the
7public interest, safety, and welfare.
8    (f) In order to provide for the expeditious and timely
9implementation of the State's fiscal year 2001 budget,
10emergency rules to implement any provision of this amendatory
11Act of the 91st General Assembly or any other budget initiative
12for fiscal year 2001 may be adopted in accordance with this
13Section by the agency charged with administering that provision
14or initiative, except that the 24-month limitation on the
15adoption of emergency rules and the provisions of Sections
165-115 and 5-125 do not apply to rules adopted under this
17subsection (f). The adoption of emergency rules authorized by
18this subsection (f) shall be deemed to be necessary for the
19public interest, safety, and welfare.
20    (g) In order to provide for the expeditious and timely
21implementation of the State's fiscal year 2002 budget,
22emergency rules to implement any provision of this amendatory
23Act of the 92nd General Assembly or any other budget initiative
24for fiscal year 2002 may be adopted in accordance with this
25Section by the agency charged with administering that provision
26or initiative, except that the 24-month limitation on the

 

 

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1adoption of emergency rules and the provisions of Sections
25-115 and 5-125 do not apply to rules adopted under this
3subsection (g). The adoption of emergency rules authorized by
4this subsection (g) shall be deemed to be necessary for the
5public interest, safety, and welfare.
6    (h) In order to provide for the expeditious and timely
7implementation of the State's fiscal year 2003 budget,
8emergency rules to implement any provision of this amendatory
9Act of the 92nd General Assembly or any other budget initiative
10for fiscal year 2003 may be adopted in accordance with this
11Section by the agency charged with administering that provision
12or initiative, except that the 24-month limitation on the
13adoption of emergency rules and the provisions of Sections
145-115 and 5-125 do not apply to rules adopted under this
15subsection (h). The adoption of emergency rules authorized by
16this subsection (h) shall be deemed to be necessary for the
17public interest, safety, and welfare.
18    (i) In order to provide for the expeditious and timely
19implementation of the State's fiscal year 2004 budget,
20emergency rules to implement any provision of this amendatory
21Act of the 93rd General Assembly or any other budget initiative
22for fiscal year 2004 may be adopted in accordance with this
23Section by the agency charged with administering that provision
24or initiative, except that the 24-month limitation on the
25adoption of emergency rules and the provisions of Sections
265-115 and 5-125 do not apply to rules adopted under this

 

 

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1subsection (i). The adoption of emergency rules authorized by
2this subsection (i) shall be deemed to be necessary for the
3public interest, safety, and welfare.
4    (j) In order to provide for the expeditious and timely
5implementation of the provisions of the State's fiscal year
62005 budget as provided under the Fiscal Year 2005 Budget
7Implementation (Human Services) Act, emergency rules to
8implement any provision of the Fiscal Year 2005 Budget
9Implementation (Human Services) Act may be adopted in
10accordance with this Section by the agency charged with
11administering that provision, except that the 24-month
12limitation on the adoption of emergency rules and the
13provisions of Sections 5-115 and 5-125 do not apply to rules
14adopted under this subsection (j). The Department of Public Aid
15may also adopt rules under this subsection (j) necessary to
16administer the Illinois Public Aid Code and the Children's
17Health Insurance Program Act. The adoption of emergency rules
18authorized by this subsection (j) shall be deemed to be
19necessary for the public interest, safety, and welfare.
20    (k) In order to provide for the expeditious and timely
21implementation of the provisions of the State's fiscal year
222006 budget, emergency rules to implement any provision of this
23amendatory Act of the 94th General Assembly or any other budget
24initiative for fiscal year 2006 may be adopted in accordance
25with this Section by the agency charged with administering that
26provision or initiative, except that the 24-month limitation on

 

 

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1the adoption of emergency rules and the provisions of Sections
25-115 and 5-125 do not apply to rules adopted under this
3subsection (k). The Department of Healthcare and Family
4Services may also adopt rules under this subsection (k)
5necessary to administer the Illinois Public Aid Code, the
6Senior Citizens and Disabled Persons Property Tax Relief Act,
7the Senior Citizens and Disabled Persons Prescription Drug
8Discount Program Act (now the Illinois Prescription Drug
9Discount Program Act), and the Children's Health Insurance
10Program Act. The adoption of emergency rules authorized by this
11subsection (k) shall be deemed to be necessary for the public
12interest, safety, and welfare.
13    (l) In order to provide for the expeditious and timely
14implementation of the provisions of the State's fiscal year
152007 budget, the Department of Healthcare and Family Services
16may adopt emergency rules during fiscal year 2007, including
17rules effective July 1, 2007, in accordance with this
18subsection to the extent necessary to administer the
19Department's responsibilities with respect to amendments to
20the State plans and Illinois waivers approved by the federal
21Centers for Medicare and Medicaid Services necessitated by the
22requirements of Title XIX and Title XXI of the federal Social
23Security Act. The adoption of emergency rules authorized by
24this subsection (l) shall be deemed to be necessary for the
25public interest, safety, and welfare.
26    (m) In order to provide for the expeditious and timely

 

 

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1implementation of the provisions of the State's fiscal year
22008 budget, the Department of Healthcare and Family Services
3may adopt emergency rules during fiscal year 2008, including
4rules effective July 1, 2008, in accordance with this
5subsection to the extent necessary to administer the
6Department's responsibilities with respect to amendments to
7the State plans and Illinois waivers approved by the federal
8Centers for Medicare and Medicaid Services necessitated by the
9requirements of Title XIX and Title XXI of the federal Social
10Security Act. The adoption of emergency rules authorized by
11this subsection (m) shall be deemed to be necessary for the
12public interest, safety, and welfare.
13    (n) In order to provide for the expeditious and timely
14implementation of the provisions of the State's fiscal year
152010 budget, emergency rules to implement any provision of this
16amendatory Act of the 96th General Assembly or any other budget
17initiative authorized by the 96th General Assembly for fiscal
18year 2010 may be adopted in accordance with this Section by the
19agency charged with administering that provision or
20initiative. The adoption of emergency rules authorized by this
21subsection (n) shall be deemed to be necessary for the public
22interest, safety, and welfare. The rulemaking authority
23granted in this subsection (n) shall apply only to rules
24promulgated during Fiscal Year 2010.
25    (o) In order to provide for the expeditious and timely
26implementation of the provisions of the State's fiscal year

 

 

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12011 budget, emergency rules to implement any provision of this
2amendatory Act of the 96th General Assembly or any other budget
3initiative authorized by the 96th General Assembly for fiscal
4year 2011 may be adopted in accordance with this Section by the
5agency charged with administering that provision or
6initiative. The adoption of emergency rules authorized by this
7subsection (o) is deemed to be necessary for the public
8interest, safety, and welfare. The rulemaking authority
9granted in this subsection (o) applies only to rules
10promulgated on or after the effective date of this amendatory
11Act of the 96th General Assembly through June 30, 2011.
12    (p) In order to provide for the expeditious and timely
13implementation of the provisions of Public Act 97-689,
14emergency rules to implement any provision of Public Act 97-689
15may be adopted in accordance with this subsection (p) by the
16agency charged with administering that provision or
17initiative. The 150-day limitation of the effective period of
18emergency rules does not apply to rules adopted under this
19subsection (p), and the effective period may continue through
20June 30, 2013. The 24-month limitation on the adoption of
21emergency rules does not apply to rules adopted under this
22subsection (p). The adoption of emergency rules authorized by
23this subsection (p) is deemed to be necessary for the public
24interest, safety, and welfare.
25    (q) In order to provide for the expeditious and timely
26implementation of the provisions of Articles 7, 8, 9, 11, and

 

 

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112 of this amendatory Act of the 98th General Assembly,
2emergency rules to implement any provision of Articles 7, 8, 9,
311, and 12 of this amendatory Act of the 98th General Assembly
4may be adopted in accordance with this subsection (q) by the
5agency charged with administering that provision or
6initiative. The 24-month limitation on the adoption of
7emergency rules does not apply to rules adopted under this
8subsection (q). The adoption of emergency rules authorized by
9this subsection (q) is deemed to be necessary for the public
10interest, safety, and welfare.
11    (r) In order to provide for the expeditious and timely
12implementation of the provisions of this amendatory Act of the
1398th General Assembly, emergency rules to implement this
14amendatory Act of the 98th General Assembly may be adopted in
15accordance with this subsection (r) by the Department of
16Healthcare and Family Services. The 24-month limitation on the
17adoption of emergency rules does not apply to rules adopted
18under this subsection (r). The adoption of emergency rules
19authorized by this subsection (r) is deemed to be necessary for
20the public interest, safety, and welfare.
21    (s) In order to provide for the expeditious and timely
22implementation of the provisions of Sections 5-5b.1 and 5A-2 of
23the Illinois Public Aid Code, emergency rules to implement any
24provision of Section 5-5b.1 or Section 5A-2 of the Illinois
25Public Aid Code may be adopted in accordance with this
26subsection (s) by the Department of Healthcare and Family

 

 

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1Services. The rulemaking authority granted in this subsection
2(s) shall apply only to those rules adopted prior to July 1,
32015. Notwithstanding any other provision of this Section, any
4emergency rule adopted under this subsection (s) shall only
5apply to payments made for State fiscal year 2015. The adoption
6of emergency rules authorized by this subsection (s) is deemed
7to be necessary for the public interest, safety, and welfare.
8    (t) In order to provide for the expeditious and timely
9implementation of the provisions of this amendatory Act of the
1099th General Assembly, emergency rules to implement this
11amendatory Act of the 99th General Assembly may be adopted in
12accordance with this subsection (t) by the Department of
13Healthcare and Family Services. The 24-month limitation on the
14adoption of emergency rules does not apply to rules adopted
15under this subsection (t). The adoption of emergency rules
16authorized by this subsection (t) is deemed to be necessary for
17the public interest, safety, and welfare.
18(Source: P.A. 98-104, eff. 7-22-13; 98-463, eff. 8-16-13;
1998-651, eff. 6-16-14; 99-2, eff. 3-26-15.)
 
20    Section 10. The Mental Health and Developmental
21Disabilities Administrative Act is amended by changing Section
227.1 and by adding Sections 75, 75.01, 75.02, 75.03, 75.04,
2375.05, 75.06, 75.07, 75.08, 75.09, 75.10, 75.11, 75.12, 75.13,
2475.14, 75.15, 75.16, and 75.17 as follows:
 

 

 

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1    (20 ILCS 1705/7.1)  (from Ch. 91 1/2, par. 100-7.1)
2    Sec. 7.1. To assist families to place children with mental
3illness, for whom no appropriate care is available in
4Department facilities, in licensed private facilities, the
5Department shall supplement the amount a family is able to pay,
6as determined by the Department and the amount available from
7other sources, provided the Department's share shall not exceed
8a uniform maximum rate to be determined from time to time by
9the Department. The Department of Healthcare and Family
10Services may exercise such authority under this Section as is
11necessary to implement the provisions of Section 5.23 of the
12Illinois Public Aid Code and to administer Individual Care
13Grants.
14(Source: P.A. 88-380.)
 
15    (20 ILCS 1705/75 new)
16    Sec. 75. Purpose; transfer of certain rights, powers,
17duties, and functions; application of Sections 75.01 through
1875.17.
19    (a) It is the purpose of this Part to transfer to the
20Department of Healthcare and Family Services certain rights,
21powers, and duties currently exercised by the Department of
22Human Services related to Individual Care Grants for children
23with complex behavioral health needs. This transfer is intended
24to make possible the more effective and efficient operation of
25Individual Care Grant services.

 

 

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1    (b) Certain rights, powers, and duties currently exercised
2by the Department of Human Services related to Individual Care
3Grants for children with complex behavioral health needs are
4transferred to the Department of Healthcare and Family Services
5with the transfer and transition of the Individual Care Grant
6program to the Department of Healthcare and Family Services to
7be completed and implemented within 6 months after the
8effective date of this amendatory Act of the 99th General
9Assembly, as provided in Section 7.1 of this Act and Section 15
10of this amendatory Act of the 99th General Assembly. For the
11purposes of the Successor Agency Act, the Department of
12Healthcare and Family Services is declared to be the successor
13agency of the Department of Human Services, but only with
14respect to the functions of the Department of Human Services
15that are transferred to the Department of Healthcare and Family
16Services under this amendatory Act of the 99th General
17Assembly.
18    (c) Sections 75.01 through 75.17 (this Part) shall
19supersede any rules of the Department of Human Services
20regarding which children are eligible to receive funds for an
21Individual Care Grant hereinafter referred to as "ICG" due to
22their mental illness, including intensive community services
23or residential placement, when clinically appropriate.
24Comprehensive services are to be funded to assist in reducing
25the child's severity of symptoms and illness to maintain the
26individual in the least restrictive setting that is clinically

 

 

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1appropriate. With the goal of keeping families unified, funds
2shall be provided to assist parents or guardians in obtaining
3necessary services and support for children with complex
4behavioral health needs, not just children with psychosis.
5    (d) In addition to the other statutory provisions regarding
6Individual Care Grants, this Part is intended to supplement and
7provide procedures for Individual Care Grants. However, if
8there is a conflict between anything contained in the other
9statutory provisions, those other statutory provisions shall
10prevail.
11    (e) This Part establishes the Children's Behavioral Health
12Cabinet. The Office of the Governor shall establish and chair a
13Children's Behavioral Health Cabinet that shall include the
14Directors of Healthcare and Family Services, Children and
15Family Services, and Juvenile Justice or their designees, the
16Secretary of Human Services or his or her designee, the State
17Superintendent of Education or his or her designee, family
18representatives, provider representatives, and other necessary
19stakeholders, as determined by the Office of the Governor, to
20inform the design and management of children's behavioral
21health services. The Children's Behavioral Health Cabinet
22shall meet at least quarterly. The Children's Behavioral Health
23Cabinet shall prepare an annual report to the General Assembly
24on or before January 30th of each year related to the
25implementation of any remedies in response to litigation
26against the Department of Healthcare and Family Services

 

 

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1related to children's behavioral health and the general status
2of children's behavioral health in this State.
 
3    (20 ILCS 1705/75.01 new)
4    Sec. 75.01. Definitions.
5    For the purposes of this Part, unless the context otherwise
6requires:
7    "Children" means individuals under 18 years of age.
8    "Days" means calendar days.
9    "Department" means the Department of Healthcare and Family
10Services.
11    "Director" means the Director of the Department of
12Healthcare and Family Services.
13    "Division of Mental Health" or "DMH" means the Department
14of Human Services, Division of Mental Health.
15    "ICG Coordinator" means staff employed by an Illinois
16screening, assessment and support services program to provide
17support, information and recommendations regarding available
18services, case coordination, and supports to youth applying for
19or with an Illinois ICG.
20    "Individual Services Plan" or "ISP" means the plan that
21identifies the child's goals and selects the level of care and
22associated services required to meet the goals.
23    "Licensed private facilities" means residential treatment
24facilities licensed by the Department of Children and Family
25Services under 89 Ill. Adm. Code 404, or, for out-of-state

 

 

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1facilities, in accordance with Section 15.1 of the Mental
2Health and Developmental Disabilities Administrative Act,
3which have been accredited by the Joint Commission on the
4Accreditation of Healthcare Organizations hereinafter referred
5to as "JCAHO" as a psychiatric facility serving children and
6adolescents or which have been surveyed and approved by the
7Department as meeting standards equivalent to standards for
8psychiatric facilities serving children and adolescents found
9in the 1997 Standards for Behavioral Health Care released by
10JCAHO.
11    "Parent or guardian" means a parent, biological, or
12adoptive, or an individual appointed as legal guardian by the
13court under the Probate Act of 1975. A parent or guardian does
14not include a governmental agency or social service agency, or
15any employee thereof, appointed by a court as guardian or
16custodian.
17    "Residential facility" means a facility providing 24-hour
18supervised out-of-home therapeutic care, including, but not
19limited to: single or multiple site program sites or apartments
20that provide a 24-hour supervised environment.
21    "SASS" or "Screening, Assessment and Support Services"
22means short-term, crisis intervention mental health services
23that are provided to children who are at risk or who actually
24experience hospitalization due to psychiatric reasons.
25    "Staff" means employees or persons under contract with the
26Department.

 

 

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1    "Young adults" means individuals 18 through 21 years of
2age.
3    "Young adult support services" means time-limited funding
4for young adults to cover costs of services and supports, not
5included under other programs for which the person may be
6eligible, to aid the young adult in his or her transition to
7community living and funding that can be applied to the costs
8of a supported living arrangement or other appropriate
9transitional services that help to integrate the young adult
10into his or her adult roles in the community.
 
11    (20 ILCS 1705/75.02 new)
12    Sec. 75.02. Stakeholder Committee.
13    (a) The Department of Healthcare and Family Services shall
14establish an ICG Stakeholder Committee comprised of parents,
15youth, provider representatives, representation from the
16Department of Children and Family Services, representation
17from the Department of Human Services, representation from the
18Department of Juvenile Justice, representation from the CCBYS
19program and other stakeholders as determined by the Department.
20    (b) The ICG Stakeholder Committee shall meet on a quarterly
21basis.
22    (c) All potential program changes shall be presented to the
23ICG Stakeholder Committee for discussion and input prior to
24implementation.
 

 

 

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1    (20 ILCS 1705/75.03 new)
2    Sec. 75.03. Eligibility criteria for an individual care
3grant. In order to be eligible for ICG funding, the following
4criteria must be met:
5    (1) The parent or guardian must be a resident of this
6State, as defined in Section 2-10 of the Illinois Public Aid
7Code.
8    (2) The child must:
9        (A) have a diagnosis, which the current symptoms do not
10    represent a single acute episode from which rapid and
11    substantial remission is likely, of: schizophrenia
12    spectrum and other psychotic disorders; bipolar and
13    related disorders; depressive disorders; anxiety
14    disorders; obsessive-compulsive and related disorders;
15    trauma-related and stressor-related disorders;
16    dissociative disorders; or somatic symptom disorders;
17        (B) must not be older than 17 1/2 years of age at the
18    time of prior authorization;
19        (C) must meet medical necessity standards as
20    established in Section 75.04 by the Department; and
21    (3) The child must not be under the guardianship of another
22State agency that has financial and legal responsibility for
23the youth.
 
24    (20 ILCS 1705/75.04 new)
25    Sec. 75.04. Medical necessity.

 

 

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1    (a) The Department of Healthcare and Family Services shall,
2in collaboration with the Department of Human Services and the
3Department of Children and Family Services, establish the
4appropriate clinical standards for Community ICG Services and
5Residential ICG Services, using the Child and Adolescent Needs
6and Strengths (CANS) Assessment, within 6 months of the
7effective date of this Part. The Department of Healthcare and
8Family Services shall review the clinical threshold with the
9Department of Human Services and the Department of Children and
10Family Services, annually.
11    (b) Through the use of the CANS Assessment, a child's needs
12shall be stratified across tiers of service intensity. ICG
13community services shall have a different clinical threshold
14than ICG residential services.
15    (c) Families shall be notified of the intensity of services
16for which their child qualifies: ICG community or ICG
17residential. A family may always select to substitute lower
18intensity services for higher intensity services.
19    (d) The Department of Healthcare and Family Services shall
20continue to use the existing methods of determining clinical
21appropriateness until it transitions to the utilization of the
22CANS Assessment, as detailed in this Section.
23    (e) Children placed in a residential setting shall undergo
24a continued stay review, as established by the Department of
25Healthcare and Family Services. A child placed in ICG community
26services shall undergo a clinical review every 6 months.
 

 

 

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1    (20 ILCS 1705/75.05 new)
2    Sec. 75.05. Emergency individual care grants.
3    (a) To be eligible for an emergency temporary individual
4care grant:
5        (1) the child and family must meet the eligibility
6    requirements in Section 75.03;
7        (2) a child receiving inpatient psychiatric care (for
8    example at a psychiatric hospital or similar facility) who
9    is ready for discharge and who is not able to return home
10    due to the safety of the child, family, or individual may
11    be awarded a temporary emergency grant for a period of 90
12    days; and
13        (3) the attending child and adolescent psychiatrist
14    must recommend that the child is in need of on-going 24
15    hour supervision, such as residential placement.
16    (b) During the 90-day period complete the ICG prior
17authorization process in accordance with this Part.
18    (c) Section 75.11 applies to decisions under this Section.
 
19    (20 ILCS 1705/75.06 new)
20    Sec. 75.06. ICG application reform, prior authorization
21process, re-authorization process.
22    (a) The Department of Healthcare and Family Services shall
23replace the existing ICG application process with a simplified
24service prior authorization process on or before 6 months after

 

 

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1the effective date of this amendatory Act of the 99th General
2Assembly.
3    (b) The Department's simplified service prior
4authorization process shall include the following:
5        (1) demographic details regarding the child;
6        (2) clinical diagnosis verified by an LPHA within the
7    last 6 months;
8        (3) completed CANS scores;
9        (4) history of inpatient and residential care;
10        (5) history of SASS services;
11        (6) history of behavioral health services;
12        (7) signed authorization detailing need for
13    residential care by a LPHA;
14        (8) family details, including a signed statement of
15    engagement indicating that the family will participate in
16    treatment and that the child will have a place of residency
17    upon discharge from treatment.
18    (c) The Department of Healthcare and Family Services shall
19establish a process for reviewing and authorizing prior
20authorization requests within 5 days of submission.
21    (d) The Department of Healthcare and Family Services shall
22re-authorize grants every 6 months, so long as the child is
23under the age of 21.
24    (e) The parent or guardian, child (if appropriate), and
25provider shall be notified in writing, 6 weeks prior to the
26anniversary date of the Department of Healthcare and Family

 

 

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1Services decision to re-authorize or terminate funding.
 
2    (20 ILCS 1705/75.07 new)
3    Sec. 75.07. Parent or guardian responsibilities;
4resources.
5    (a) The parent or guardian of a child receiving an ICG must
6participate in the child's care, treatment, and is willing to
7accept the child home upon discharge to the community.
8    (b) When a youth is placed in residential care, the
9residential provider shall apply for all public sources of
10financial support available to or for the child, including but
11not limited to Social Security Administration ("SSA") benefits
12and supplemental security income ("SSI") authorized under 42
13U.S.C. 1381, and these funds must be applied to the costs of
14residential care, to the extent provided by law.
15    (c) Upon placement in residential care, if the child is not
16already receiving benefits from SSA, the parent or guardian
17shall authorize the residential placement staff to initiate an
18application for SSI immediately after placement or on the 90th
19day, depending on family income levels. If the child is
20receiving benefits from SSA upon admission into residential
21care, the parent or guardian shall authorize the residential
22placement staff to initiate an application on behalf of the
23residential agency to become payee for SSA benefits.
24    (d) The parent or guardian must notify the Department of
25Healthcare and Family Services of any changes in the level of

 

 

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1financial support from public sources. Declaration of
2ineligibility, reduction of benefits, or loss of benefits
3through the actions of another governmental agency shall not
4affect the Department's continued funding, unless these
5actions are the consequence of the parent or guardian's failure
6to pursue benefits or comply with this Section.
7    (e) All financial assets of the child exceeding an exempt
8amount established by the Department of Healthcare and Family
9Services must be applied to the costs of residential care. The
10determination that certain assets may be exempt is subject to
11the Department's review and approval.
12    (f) If the child is covered by private medical insurance,
13it is primary coverage for community or residential services.
14The ICG shall be considered secondary coverage.
15    (g) The parent or guardian must notify the Department of
16Healthcare and Family Services of any changes of address for
17the parent or guardian.
18    (h) The parent or guardian must notify the Department of
19Healthcare and Family Services of any changes of guardianship
20or custody.
 
21    (20 ILCS 1705/75.08 new)
22    Sec. 75.08. ICG service appeals, denials, and complaints.
23The Department of Healthcare and Family Services shall adopt
24rules for addressing service appeals, grant denials (including
25re-authorization determinations) and complaints related to the

 

 

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1ICG program. The appeals and denial process shall include a
2Director's Level Review process and funding of a child's ICG
3shall continue through all appeals processes.
 
4    (20 ILCS 1705/75.09 new)
5    Sec. 75.09. Individual Services Plan Development.
6    (a) When the individual has been determined eligible for
7community or residential ICG, the ICG Program Office shall
8refer the parent or guardian to the appropriate SASS agency for
9the purpose of developing an individual services plan.
10    (b) The ICG Coordinator/SASS Coordinator shall provide
11support, information, and recommendations regarding available
12services and help the family determine the right services to
13meet the needs of the child and stabilize the family.
14    (c) The individual service plan shall be developed with the
15parent or guardian and appropriate service providers and must
16be reviewed and re-authorized every 6 months. The individual
17service plan shall include:
18        (1) identifying specific problems to be addressed;
19        (2) integrating all of the services to be provided;
20        (3) defining specific goals and objectives and the
21    projected duration and costs of services;
22        (4) the parent or guardian's approval of the identified
23    service providers; and
24        (5) identifying the licensed physician, clinical
25    psychologist, clinical social worker, or clinical

 

 

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1    professional counselor under whose clinical direction the
2    services will be provided and obtain, by signature, his or
3    approval of the plan.
4    (d) The development or implementation of an individual
5services plan may be deferred for one or more of the following
6conditions:
7        (1) continuing hospitalization is required;
8        (2) extended absence from the family due to the child
9    running away or a court-ordered transfer of custody or
10    guardianship to a governmental agency; or
11        (3) the parent or guardian does not wish to initiate
12    any services with ICG funding or fails to participate in
13    the individual services planning.
14    (e) If the individual services plan is not developed or
15implemented within 6 months of the ICG award, the parent or
16guardian must re-authorize the awarded ICG grant.
17    (f) A recommendation to move a child to a lower level of
18care must include a minimum of 30 days of preparation for this
19transition.
 
20    (20 ILCS 1705/75.10 new)
21    Sec. 75.10. Alternative In-home services.
22    (a) The Department of Healthcare and Family Services or its
23representative shall review individual services plans as well
24as discharge plans and may approve funding for alternative
25in-home services as described in this Section.

 

 

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1    (b) Alternative in-home services include, but are not
2limited to, care coordination, community support, crisis
3stabilization services, mentoring, respite support services,
4and young adult support services.
5    (c) ICG funding shall not be used to replace services
6authorized under 59 Ill. Adm. Code, Part 132 or other services
7for which the child and family may be eligible through federal,
8State, or local funding.
9    (d) Limits of hours and costs shall be authorized on a case
10by case basis by the Department.
 
11    (20 ILCS 1705/75.11 new)
12    Sec. 75.11. Residential placement.
13    (a) SASS staff shall discuss with the parent or guardian
14the potentially appropriate facilities based on factors such as
15the child's age, sex, and mental health condition, as well as
16locations and programs of facilities, and the requirements for
17placement and parental involvement, and shall, at the parent's
18or guardian's direction and with appropriately executed
19consents, prepare clinical referral packets to be sent to the
20facilities.
21    (b) The list of facilities appropriate for placement
22through the ICG program is comprised of facilities which:
23        (1) meet the standards for licensed private facilities
24    as defined in administrative rules;
25        (2) have an educational program approved by the

 

 

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1    Illinois State Board of Education;
2        (3) have a per diem rate that includes residential
3    services, such as room and board, but does not include
4    tuition as established for purchased care services under
5    the rules of the Illinois Purchased Care Review Board in 89
6    Ill. Adm. Code 900, the Department of Children and Family
7    Services in 89 Ill. Adm. Code 356, or the Department in
8    Section 54 of the Mental Health and Developmental
9    Disabilities Administrative Act; and
10        (4) have entered into a contract with the Department
11    for these services during the current fiscal period.
12    (c) If appropriate placement for a child cannot be obtained
13from a contracted provider, the Department may contract with
14other private facilities meeting the standards provided in
15paragraphs (1) and (2) of subsection (b) of this Section.
16    (d) The Department may negotiate for additional services
17from facilities to augment existing services or to develop a
18specialized resource for a child.
19    (e) An individual service plan shall be developed within 30
20days after placement, including expected duration and
21outcomes, by facility staff in consultation with the parent or
22guardian and the child. This individual service plan shall be
23reviewed and updated quarterly, including documentation of
24parental participation and consideration of discharge to
25in-home or community services. These updated plans and progress
26reports shall be provided quarterly to the Department or its

 

 

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1designee. Together with the goals as stated in the case record
2summary, these documents shall be the basis for the
3Department's review and approval for continuing funding for
4placement, including alternative in-home or community service
5which are part of the discharge plan.
6    (f) Parent or guardian responsibilities during placement
7include the following:
8        (1) participation in and cooperation with the
9    facility's requirements for the child's care, treatment,
10    and discharge to the family and community;
11        (2) completion and submission of any forms and
12    documents as may be required by the Department;
13        (3) the usual and customary costs of parenthood or
14    guardianship, including:
15            (A) clothing;
16            (B) medical and dental costs;
17            (C) personal allowance and incidentals; and
18            (D) transportation costs, to and from the
19        facility; and
20        (4) notifying the local education agency that the child
21    has been placed in a residential facility and requesting
22    their participation in educational planning. The local
23    education agency is responsible for the tuition costs of
24    residential placement under State law.
25    (g) Prior to residential placement, if the youth has not
26yet been identified as eligible for special education services,

 

 

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1the parent or guardian should initiate a case study evaluation
2through their local school district.
 
3    (20 ILCS 1705/75.12 new)
4    Sec. 75.12. Discharge from residential services.
5    (a) An Individual Service Plan must follow the discharge
6protocol established by the Division of Mental Health in order
7to ensure that community services are in place before
8discharge. The parent or guardian with support from an ICG
9Coordinator shall identify and procure appropriate community
10services.
11    (b) If the child is leaving the ICG program upon discharge,
12appropriate child and adolescent or adult services must be
13engaged.
 
14    (20 ILCS 1705/75.13 new)
15    Sec. 75.13. Termination of funding or services.
16ICG funding shall be terminated in any of the following
17circumstances:
18    (1) failure of the parent or guardian to meet prior
19authorization, re-authorization, or eligibility requirements;
20    (2) the child is no longer enrolled in an approved
21educational program at the elementary or high school level, or
22attainment of age 21, whichever occurs first;
23    (3) completion of residential treatment or alternative
24in-home or community services;

 

 

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1    (4) the parent or guardian is no longer an Illinois
2resident; however, funding and placement for the child may
3continue until completion of the school year;
4    (5) guardianship of the child is ordered by the court to a
5State agency;
6    (6) the child's resources, private or public, are
7sufficient to pay the costs of care;
8    (7) any 12-month period without receiving residential,
9community, or alternative in-home; or
10    (8) Upon the completion of the annual ICG renewal process,
11it is determined that the child no longer would clinically
12benefit from the services being provided.
 
13    (20 ILCS 1705/75.14 new)
14    Sec. 75.14. Monitoring. The Department shall establish
15policies and procedures related to the monitoring of
16residential, community, and alternative in-home services
17providers.
 
18    (20 ILCS 1705/75.15 new)
19    Sec. 75.15. Bed holds.
20    (a) The Department shall adopt rules regarding bed holds
21and may not reimburse a provider for more than 40 bed nights
22per State fiscal year per individual.
23    (b) An agency shall not be reimbursed for an individual's
24absence after the date of discharge or when his or her

 

 

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1treatment plan includes removal from the agency program or
2after the date of the agency's knowledge of the individual's
3pending termination.
 
4    (20 ILCS 1705/75.16 new)
5    Sec. 75.16. Children's Behavioral Health Reform.
6    (a) The Department of Healthcare and Family Services shall
7seek to maximize federal financial participation for all
8services covered under this Part and to fully integrate the ICG
9program into the Children's Behavioral Health Reform efforts
10established by the Department. To the extent that full
11integration of the ICG program into the Department of
12Healthcare and Family Services behavioral health care
13coordination entity creates a conflict with any Part of this
14Act, the Department shall establish provisional policies that
15shall be in effect for the term of the agreement between the
16Department of Healthcare and Family Services and any such care
17coordination entity.
18    (b) The Department shall establish an updated ICG Program
19design. The Department shall work collaboratively with the
20Division of Mental Health and the Department of Children and
21Family Services as it establishes an implementation plan for
22Children's Behavioral Health Reform and adopt new rules
23detailing the operation of an updated ICG Program that
24coordinates service delivery and design before December 31,
252016.
 

 

 

HB4096 Engrossed- 32 -LRB099 07770 RLC 27903 b

1    (20 ILCS 1705/75.17 new)
2    Sec. 75.17. Repeal. Sections 75 through 75.17 are repealed
3on January 1, 2018.
 
4    Section 15. The Illinois Public Aid Code is amended by
5changing Section 5-5.23 as follows:
 
6    (305 ILCS 5/5-5.23)
7    Sec. 5-5.23. Children's mental health services.
8    (a) The Department of Healthcare and Family Services, by
9rule, shall require the screening and assessment of a child
10prior to any Medicaid-funded admission to an inpatient hospital
11for psychiatric services to be funded by Medicaid. The
12screening and assessment shall include a determination of the
13appropriateness and availability of out-patient support
14services for necessary treatment. The Department, by rule,
15shall establish methods and standards of payment for the
16screening, assessment, and necessary alternative support
17services.
18    (b) The Department of Healthcare and Family Services, to
19the extent allowable under federal law, shall secure federal
20financial participation for Individual Care Grant expenditures
21made by the Department of Healthcare and Family Services of
22Human Services for the Medicaid optional service authorized
23under Section 1905(h) of the federal Social Security Act,

 

 

HB4096 Engrossed- 33 -LRB099 07770 RLC 27903 b

1pursuant to the provisions of Section 7.1 of the Mental Health
2and Developmental Disabilities Administrative Act. The
3Department of Healthcare and Family Services may exercise such
4authority under this Section as is necessary to administer
5Individual Care Grants as authorized under Section 7.1 of the
6Mental Health and Developmental Disabilities Administrative
7Act.
8    (c) The Department of Healthcare and Family Services shall
9work collaboratively with the Department of Children and Family
10Services and the Division of Mental Health of jointly with the
11Department of Human Services to implement subsections (a) and
12(b).
13    (d) On and after July 1, 2012, the Department shall reduce
14any rate of reimbursement for services or other payments or
15alter any methodologies authorized by this Code to reduce any
16rate of reimbursement for services or other payments in
17accordance with Section 5-5e.
18(Source: P.A. 97-689, eff. 6-14-12.)
 
19    Section 99. Effective date. This Act takes effect upon
20becoming law.